CAJ | 학술논문

目的：探讨磁共振弥散加权成像在胃恶性肿瘤诊断中的价值。方法收集临床病理确诊的胃恶性肿瘤患者48例作为病例组，其中胃腺癌38例，胃淋巴瘤10例。另随机选取健康志愿者20例作为对照组。所有患者均在治疗前行常规 MRI（T1 WI 、T2 WI）及弥散加权成像扫描（弥散敏感因子 b 值取0，800）。利用计算机软件直接测量肿瘤组织的信号强度值及 ADC 值，取其平均值。同样的方法获得对照组胃壁的 ADC 值，对获得的数据进行组间对照研究。结果常规 MRI 胃恶性肿瘤检出敏感性为91．7％（44／48）；DWI 成像检出的敏感性为100％（48／48）；DWI 病灶部位信号强度值明显高于对照组，胃恶性肿瘤平均信号强度值为345．33±170．10，正常胃壁平均信号强度值为149．80±36．24；在 b 值为800s／mm2时，胃恶性肿瘤平均 ADC 值是（0．87 ± 0．11）×10‐3 mm2／s ，正常胃壁平均 ADC 值是（1．79 ± 0．11）×10‐3 mm2／s ，两者之间差异有统计学意义（ P ＜ 0．05）。胃腺癌患者平均 ADC 值是（0．83 ± 0．07）×10‐3 mm2／s ，胃淋巴瘤患者平均ADC 值是（1．03 ± 0．07）×10‐3 mm2／s ，两者之间差异具有统计学意义（ P ＜ 0．05）。结论磁共振弥散加权成像在胃恶性肿瘤诊断及鉴别诊断中具有明显的应用价值。
목적：탐토자공진미산가권성상재위악성종류진단중적개치。방법수집림상병리학진적위악성종류환자48례작위병례조，기중위선암38례 ，위림파류10례。령수궤선취건강지원자20례작위대조조。소유환자균재치료전행상규 MRI（T1 WI 、T2 WI）급미산가권성상소묘（미산민감인자 b 치취0，800）。이용계산궤연건직접측량종류조직적신호강도치급 ADC 치，취기평균치。동양적방법획득대조조위벽적 ADC 치，대획득적수거진행조간대조연구。결과상규 MRI 위악성종류검출민감성위91．7％（44／48）；DWI 성상검출적민감성위100％（48／48）；DWI 병조부위신호강도치명현고우대조조，위악성종류평균신호강도치위345．33±170．10，정상위벽평균신호강도치위149．80±36．24；재 b 치위800s／mm2시，위악성종류평균 ADC 치시（0．87 ± 0．11）×10‐3 mm2／s ，정상위벽평균 ADC 치시（1．79 ± 0．11）×10‐3 mm2／s ，량자지간차이유통계학의의（ P ＜ 0．05）。위선암환자평균 ADC 치시（0．83 ± 0．07）×10‐3 mm2／s ，위림파류환자평균ADC 치시（1．03 ± 0．07）×10‐3 mm2／s ，량자지간차이구유통계학의의（ P ＜ 0．05）。결론자공진미산가권성상재위악성종류진단급감별진단중구유명현적응용개치。
Objective To explore the value of magnetic resonance diffusion weighted imaging in the diagnosis of malig ‐nant gastric tumor .Methods 48 patients with malignant gastric tumor were selected as case group ,inchuding 38 patients with adenocarcinom ,10 patients with lymphoma . All these were confirmed by pathological examination . Another 20 healthy people were randomly selected as control group .Before treatment ,conventional MRI and DWI were performed in 48 patients .The ADC value and signal density were measured based on the gastric tumoral entities and normal gastric mu‐cosa in the control group .Single‐factor analysis of variance was used to compare ADC values and signal density of patients with gastric malignancy and patients in control group .Results The sensitivity of conventional MRI and DWI was 92%(44/48) and 100% (48/48) .The average signal density in gastric tumoral group was higher than normal gastric wall ( P< 0 .05) on DWI .Mean ADC values were(0 .87 ± 0 .11) × 10‐3 mm2 /s and (1 .79 ± 0 .11) × 10‐3 mm2 /s ,in gastric tumor group and in control group ,respectively ,being statistically significant ( P < 0 .05) .Mean ADC values were(0 .83 ± 0 .07) × 10‐3 mm2 /s and (1 .03 ± 0 .07) × 10‐3 mm2 /s ,in the adenocarcinoma and lymphoma group ,The comparison of the ADC values in the adenocarcinoma and lymphoma cases were also found to be statistically significant ( P < 0 .05) .Conclusion DWI is beneficial in the diagnosis of malignant gastric lesions by the aid of ADC measurements .It is helpful for identifica‐tion in gastric malignant tumors .